How I Went Off Sleeping Pills

I had been taking Ambien in various forms (CR high and low dose, regular high and low dose) for about 15 months. When I went on it I was in a place of desperation because of extreme and chronic insomnia and anxiety. I had tried every single conceivable herbal or non-invasive remedy out there. I'd had a sleep study that showed that yes, I had mild sleep apnea and yes, I was only sleeping 50-60% of the time and no, there is no reason we can find for it. I am by no means quick to request medication and am typically highly skeptical of a prescription. But I swear to the Flying Spaghetti Noodle Monster that I don't for one millisecond regret taking sleeping pills. Paired with anti-anxiety medication, it was absolutely what I needed at that point in my life.

However, a year later my life circumstances had become more stable, and my brain chemistry had recalibrated. While a sleeping pill used to give me a 7-9 hour respite, I was now sleeping for 12 hours and groggy for 14, even after tapering down from Ambien Continued Release to Ambien (Standard) in the lowest dose available. My body was telling me that it was time to move on.

So for myself, and anyone else wanting to change medication, I knew the first step was to talk to my doctor. And from here is where I draw inspiration for this post. The conversation went a little something like this:
S: I want to go off Ambien.
Dr.: Why? Is it not working?
S: It's working too well. I'm sleeping for 12 hours a night and I'm very groggy.
Dr.: Ok. We can put you on something else.
S: No, I don't want anything else. I don't want anything. I don't think I need it anymore. And it scares me to be on it long-term.
Dr: Oh it's safe. We have patients that are on it for years.
S: Sooo.......how do I go off?
Dr: Oh...um....well, I guess
S's brain: {why don't you *know*??}
Dr: ...........I guess you'll cut them in half for about 2 weeks. Then you should be good.

Um,.....*not* how this story went. I can't say that he wasn't supportive, but I got the distinct impression that in this practice, they very infrequently foster patients *off* of sleeping pills. As for the long-term safety...I'm pretty skeptical. I'm not a doctor, but I am a biologist and I am certainly capable of finding and interpreting peer-reviewed publications. Guess what? A medium search for Ambien studies defined "long-term" use as 30-60 days. (Medium search being between a 3-click lazy search and an intensive 3-day search.) One to two months, not one to two years. I stopped looking for evidence. I don't want to know. If there's damage, it's already been done. But I have a lot of faith in the brains' plasticity, and even more faith in my own judgement.

Because I had been taking the drug for so long, an abbreviated taper down schedule as outlined by my doctor was not going to work for me. I doubt it would work for anyone in the same situation. Bitter. Moving on.

I started out on the lowest prescribed dose (5 mg) of regular, ie not continued release, Ambien. I cut these in half, and switched every other night between a full dose (5mg) and a half dose (2.5mg). So, over the course of a week I had 75% Ambien in my system compared to the week before. I stayed here for about 2 weeks, before adding in another night of a half-pill. So now it was one night at 5 mg, 2 nights at 2.5 mg. After a few weeks here I move on to 2.5 mg nearly every night, and a full dose about once a week. This once a week was usually in situations where my routine was off- vising people, staying out late, etc etc. Anything that would disrupt my routine and cause excess stimulation, which my brain interprets as stress. My body responds with an elevated heart rate and pulse, breathing quickly-yeah, no sleep for you.

Eventually I was taking 2.5 mg a night. From there I cut those in half, and followed my same protocol outlined above with every other night, every two nights, once or twice a week....Finally, I was at the point where I was only taking 1/4 of a 5mg Ambien pill every 3 or 4 nights. I made the leap to go cold turkey at that point. The whole process took me about 4 months. The advantage of slowly tapering off was that I didn't have any withdrawal or kick-back insomnia. I was very motivated to avoid withdrawal effects that would worsen my anxiety (I am still on that med.) Perhaps someone without concurrent anxiety/ depression could go off more quickly.

I have been completely off sleep medication for about a month. I don't sleep great (there's still that sleep apnea), but I do sleep well enough. I signed up for a computer-based Cognitive Behavior Training for Insomnia. I'll post more after I've completed it- I don't like to write about things I haven't tried myself. I am on a cleansing program (Dr. Natura Colonix) to eliminate all vestiges of Ambien from my system.

I still want to pursue the source of my poor sleep and other health problems. This winter, after my defense, I'm going to try an elimination diet to look for gluten or other food sensitivities. I know that something internal is causing bad skin, distended stomach, insomnia, and possible even anxiety and sleep apnea. Has anyone out there tried this?

If you're out there and looking for support to go off sleep medication, I hope this helps. But keep in mind I sure as hell am not a medical professional.

Blogroll

New links! These blogs are not limited to the topics below, but this is why they appeal to me:

$5 Dinners- Quick, affordable meals
A Slob Comes Clean- aka, my home too
Amy's Finer Things- hosting a year-long declutter challenge
Chow Bella- Science! Food! Awesome. Mostly food and awesomeness. Scientist IRL.
I Heart Faces- photography
Knock Off Wood- make things!
Made By Joel- make toys!
Me Ra Koh- photography
Money Saving Mom- how to things for free
Once A Month Mom- lots of food, less cooking

Declutter Challenge

Well, my goal of 730 ft cubed was waaay overambitious. As of right now I'm at 20 ft cubed. Still, it has changed how I approach my junk...I'm a lot more willing to get rid of things I would have kept in the past. I'm learning that just because something has another use, doesn't mean I have to be the one to use it. That's a hard thing for a tree-hugger to accept.

I'm finding all kinds of treasures too: ex: a cutting board of 4 different woods my Dad made for my Mom their first Christmas together. (They divorced when I was 7 and I find that I am incredibly sentimental over any artifacts I can find from when they were together. Odd, since most of my memories start at 8- it's not like I'm missing that time in my life- I can't remember it! I wonder if this is a typical child-of-divorce thing?)

Ex: an old bug barn, inscribed with 'Bug-el: A safe haven.' I didn't like bugs then. Wonder what I was thinking?


Ex: A battery-operated orange tabby cat my late grandmother gave me. We'd had an orange tabby with a litter of four; the kittens eventually found a home on their farm & 5 acres.

I haven't really had much time to go through things, so I do expect those numbers to go up every month. But the little bit has made a difference- I was able to turn one of our two junk rooms into a usable space. It's officially the man-room, and was Booker's Valentine's Present. My hope is that in the next month or so we'll really start to see a difference in clutter and open space.

See Amy's Finer Things for a community declutter challenge.

Off to a start...good? Definately a start...

Got rid of 4.8 Ft (cubed) today by spreading the last 3 (out of about 50) bales of pine straw we ordered over the summer. We fancied up out front garden beds, which had previously consisted of some nice shrubs we planted, lost among various weeds which we did not. We are sooo *that* house. We'd also thrown down a bunch in our side yard where grass won't grow. (But about 3 species of invasive vine, will...). The last three bales went under a cherry laurel tree in our back yard. I haven't had much time to do major soring and Goodwill-ing yet. There is a box slowly filling up, but so far the count is based on paper clutter.

730 in 365 Clutter Challenge

Amy at 'Amy's Finer Things' is hosting, and I am jumping on board. (Annnd all these blog challenges will get me blogging again. Yayz.)

I'm tailoring it to my own specifications. I am a pretty spatially-motivated person. I guess having less stuff would make it easier to clean, but in full disclosure we don't really clean at all. I just last week accepted that we, as two otherwise competent adults, need a chore chart. But my biggest motivator is that I want to see empty space. It's why I love hotels so much. The rooms are just so...blank.

So, I am going with a spatial measurement for my challenge: 730 ft cubed in 365. I want to know how big of a space full of crap I'm eliminating.

And to fill this 730 ft (cubed) I'll pick through the following:

- Paper clutter is a big problem for us- me- so I'm counting 1) the basketfuls of paper we recycle 2) the bagfuls of paper we shred. I'm not counting other recycling because it's not a problem. The old beer bottles don't infilitrate all rooms of the house and find a way to be packed for every move. Also not counting basic household trash. I do have it in me to measure the cat litter, in the name of accuracy, so Imma go ahead and draw that line in the sand reeeaaall early.

- A few months ago we moved a bunch of my childhood stuff from Midwest State, doubling our junk rooms in the house. We have a spare bedroom (guest room) and an converted garage room (we'd like it to be a workout room) that are out of commission now becase they are full of mostly junk.

- We also have random items that are part of the renovations lying around. THose will count too, since once they are put in use they are still out of my breathing space.

Pantry Challenge

I'm going to participate, in my own half-ass way, in the Pantry Challenge that MoneySavingMom and FishMama are hosting. My rule is that at least once a week, we'll use up some food item that has been lurking around. Such as:

- a few nights ago I made Veggie Sloppy Joes with some TVP we've been keeping in the cupboard. I can't remember when we bought it, so I'm sure it's time to be used up.
- I also made this recipe from Smitten Kitchen that used up a bag of dried red beans and some Jasmine rice. Both also with an unknown month of purchase.

Other items I want to make use of:
- a jar of mung beans that we bought for sprouting. We always lose steam and forget to rinse the sprouts, and they rot. if we stay on top of it, it's a good wintertime food source.
- lots of rice (brown and jasmine) and canned beans.
- quinoa. It's been around awhile. I might need more than 10 fingers to count how long.
- cranberries- 2 bags. I wanted to try my hand at canning this summer, but couldn't seem to act on it while the Farmer's Market was going. Act II= cranberry sauce!
- about 8 bags of rice flour. Bought on close-out back when I thought I had a gluten problem.
- 3 half-full cans of powdered cocoa. They disappear and we keep buying more.
- 1.5 bags of semi-sweet chocolate chips.
- 4-5 boxes of Red Mill cous-cous with flax seed. Bought on closeout.
- 2-3 cans of pumpkin.
- Several lbs of chicken in various forms in the fridge.

This isn't everything in the pantry, but it's all the stuff I'm tired of looking at.

HP Touch Smart Computer GIVEAWAY

Go see Stephanie at Totally Together Reviews for entry details. Good luck!

Watch your fucking mouth!

Ok. I work at a certain retail store. It's not important where. Most of my coworkers are late teens and early twenties. We had a meeting today to go over some things and clear the air (there's been lots of silly gossip.) One of the things that I brought up was that *people*- and I included myself because I have a filthy mouth (fuck, shit, that kind of thing) - need to watch what we say, that the store is mostly loud but does have sweet spots where customers can hear us. The specific example I used is how 'r-------' and 'g---' are thrown around. (Yeah, and I am SO not okay with that.)

The reaction was kind of lukewarm, as in general agreement that yes, we should watch what we say but we all know it's not meant to be anything bad, etc etc. I beg to differ. Those offensive examples I gave to everyone don't include the times I've heard a certain specific group of people referred to in a negative way- the most outlandish being "---- people smell bad." Or the times I've heard f--, NOT in reference to a British term for a cigarette and (thankfully) not in front of my homosexual coworker. I've noticed that there's some editing. When my xyz coworkers are not there, things are said about xyz people. When the pqr coworker is not there, things are said- "jokingly"- about pqr people. More than once something that has been tossed out in a sarcastic manner has left me absolutely speechless, jaw hanging open. I try to throw out a "I don't like that word," or "What do you mean?"

I don't know. I guess I need to vent in an anonymous way. Mostly I can't believe what people think it is okay to say in any context, let alone at work. And that the most effective way to stop it seems to be "oh, we don't want the customers to hear." Am I the only one who was taught not to do that? Whether or not anyone can hear you? Is it a generational thing? Is it a regional thing?

I don't know if I should/ should not have said anything. 1) I just want to collect a paycheck and keep my nose clean at work and be cool with all my coworkers. 2) Everyone pretty much knows where I stand on some things due to my standard "I don't like that word" response. Still, I kind of got the feeling of a sense of -we're-all-adults-and-we-can-say-what-we-want-and-people-shouldn't-be-so-sensitive. But when all the terms are put together, and especially when you hear what some people say when others are not there, it paints a really nasty picture.

Blargh.

I just think that what you say MATTERS.

Blogroll

New:

MJ Palmer @ The Bottom Liner

Hope it actually added! Having technical difficulties.

Booker

Booker has just mocked his pseudonym, thusly earning an arm hair pull. He doesn't read this so I don't know why he cares.

Insomnia is Crazy-Making.

(Photo from http://www.insomnias.info/3/3.htm)

I've had problems with insomnia for the past 5 years or so. It seems to go in cycles, which have been running closer together, and for longer periods. It became unbearable this past winter, but I think I now have it under control. I still don't know what causes it, although I can eliminate an immune response to gluten. I know that it is in part anxiety-driven, but not completely. The insomnia is on 2 levels- the first, that it takes forever to fall asleep, the second, that I don't stay asleep. once awake, my mind starts spinning. At its worst, I was getting 3 hours at night and unable to nap during the day. I know a lot of people struggle with insomnia, so the point of this post is to let you what I've tried- I for one am always looking for new things to try to get some rest.
Caveat: these are suggestions only! I'm not a doctor, etc etc.


- Bed Time routine- I kind of wanted to hit the people who suggested that. Really? Can you tell me which way my underwear faces, because without you I can't function! So yeah, I have a routine of turning lights off, reading magazines, no phone calls or computer, and calming down in general.

- Benadryl, Tylenol PM, etc- Don't make me laugh. These may have worked 5 years ago when this started, but they have no effect now. I've read that a tolerance can develop quickly, and they are not meant for long-term use anyway.

- Valerian Root- doesn't work for me, but I know people who swear by it.

- Catnip tea- doesn't work for me.

- Chamomile tea, SleepyTime tea- no dice.

- Melatonin- doesn't work (for me), and it's not great to take for anything more than an occasional night. I've read that it can cause a feedback loop wherein your body produces less; what you want is for your body to produce melatonin to regulate your circadian rhythm.

- Magnesium- the theory is that you need adequate magnesium to absorb calcium. It didn't make me feel sleepy, but it did relax me which is still helpful.

- Sunlamp- my husband has a therapeutic sunlamp. You're supposed to sit in front of it for at least 15 minutes in the morning; it triggers melatonin production. I don't know about sleepiness, but it did make me feel a lot more energetic first thing in the morning.

- Brain waves- Booker has some CD's that you are supposed to listen to with headphones. They re-set your brain waves for relaxation, concentration, sleepiness. They made me noticeably more relaxed, but at its worst sleep was still elusive.

- Tryptophan supplements- the amino acid in your Thanksgiving turkey makes you sleepy. It actually helped once in a while.


Ok, time to get serious. I saw the doc for:
- Trazadone. I took this for over a year, during Booker's deployment. It worked, until it didn't. I went off and was sleeping okay- not great, but sleeping- until a new insomnia cycle started this January.

- Seroquel- I only took this for 2 weeks. It knocked me out but I didn't like the way it made me feel.

- Gluten intolerance- got a blood test to check for an immune response, which I don't seem to have. Have not yet investigated any other food sensitivities.

- Ambien CR- worked great the first week. Then not so well, then not hardly but still better than taking nothing. It had only been a month when I called about switching. The nurse told me that it is the strongest thing on the market, so if Ambien doesn't work, nothing will. Cheery.

- Sleep study- Apparently I have mild sleep apnea, but not enough episodes to warrant the mask. Doc told me to sleep on my side, which is something I intuitively do anyway. Nothing else was really revealed. When I asked him what I could do to sleep, he told me to keep taking the Ambien CR and to have a bedtime routine (see the first bullet.) Seriously dude? This was after I waited 2 hours in an empty waiting room, because "the doctor isn't in today, but he's on his way in now." Um, I drove an hour and a half to be here for a 1:30 appointment, for which you did not have the courtesy to consider until I've been here 2 hours?

This last insomnia cycle took about 4 months to get stabilized. I am still deeply interested in finding out what causes it- if it's anxiety-based (I believe in part, but not entirely), if it's partly physiological (not confident I got rid of the tapeworm, maybe food sensitivities?), or what. But for now:


- I take an anti-anxiety medication in the morning. This issue is both separate from and part of the insomnia. It helps, to an amazing degree.

- I take Ambien CR at night. It seems to work better now that I'm taking the other med. I still wake up a lot at night, but now I am able to fall back asleep whereas before I'd just spin my wheels. For hours.

- Climbing out of the hole means I have the energy and drive to take on positive habits that had fallen by the wayside. Exercise, cleaning the house so it's not a pit, taking general better care of myself so I have pride in my appearance, cooking meals for us, hanging out with people for fun, etc etc. All of these go into sleeping better at night, and I was not capable of any of them until I could even things out a bit.

- No alcohol, at all, ever. I don't metabolize it very well on a good day. It actually makes the insomnia worse- something about the sugar or preservatives. Now that I have some prescriptions I just don't want to mess with it at all.

- Continue to limit caffeine, which I have done from Day 1. Unfortunately it is a vicious cycle- the less you sleep, the more you need something to face your day.

If you have insomnia, I feel your pain. Maybe something I have tried might work for you.

RBOStuff

- I do not blog enough. I will now blog more.
- I agreed to a petition-gathering project. I wish I had not. Soliciting, even for cause I believe in, is sooo not my thing. And this project has a quota. My town is dead right now, and I have major doubts about being able to gather signatures.
- I am going to my girlfriends wedding (Hi AJH!) in Boston in less than 2 weeks! I am so excited! 1), She and her fiance have been through the fire together. I know that she is committing to someone who can really be a rock for her. And vice versa. 2), I am in dire need of some girlfriend time. I have girlfriends in Grad School Town, but somehow all we ever talk about is research and academia. I am looking forward to going out on the town in Boston.